We are NOT authorized by Govt of India for Yellow Fever Vaccination

Friday, May 29, 2015

A Healthy Checklist for Traveling Abroad

By Natalie Dicou
Headed on a once-in-a-lifetime anniversary vacation to a faraway island? How about a church mission to the tropics or a business trip to a developing country? Christie Kelts, L.P.N., has got you covered.
On any given day, Kelts — a licensed practical nurse at the University of Utah Health Care Travel Clinic — can rattle off the disease outbreaks occurring in countries around the globe. If there’s a malaria epidemic in the Dominican Republic or a dysentery problem in Mozambique, Kelts and her colleagues likely know all about it.
At the University’s Travel Clinic, jet-setters are prepared for safe and healthy forays into the potentially contagious world.
Among the world travelers who recently paid a visit to the Clinic is 24-year-old Frank who will soon embark on an epic adventure. The Weber State student will leave the country for the first time on May 6 when he travels to Ghana for a month-long humanitarian trip.
“I’ve been in America my whole life, and it’s pretty much all I know,” said Frank who got immunized for yellow fever, hepatitis A and B, and received a prescription for typhoid pills and antimalarial medication. “[Kelts] was very informed about the country especially the different precautions I need to be taking. She told me about the possible dangers with the crime there, and she warned me about jet lag. I also didn’t realize I could catch a disease while swimming.”
Said Kelts, “We don’t just give them shots and send them on their way. We talk about all the risks that are involved in travel.”
Kelts takes 30-45 minutes to educate each patient. Depending on the destination, travel risks may include everything from contracting a deadly virus to, more likely, being forced to deal with a very un-fun stomach situation.
“I tell people ‘You didn’t pay money to visit the hotel bathroom, and if you aren’t careful, that’s where you’re going to spend it,’” Kelts said.
You guessed it: Diarrhea is the most common travel illness, and there are two varieties. The less severe type is the aptly named “travelers’ diarrhea,” a non-bloody, watery diarrhea that is accompanied by mild abdominal pain but no fever. It accounts for 80% of all diarrhea cases among travelers and can occur after ingesting unsanitary food or water or even because an individual is simply not accustomed to the cuisine of a different country.
“It’s a survival mechanism,” Kelts said. “In case we do eat something bad, our system flushes it out.”
The other 20% get dysentery diarrhea with symptoms including severe abdominal cramping, fever, and diarrhea that may or may not be bloody. This more unpleasant version is caused by bacteria infecting the intestines.
When it comes to avoiding foodborne illness, the Travel Clinic has a simple mantra: If you can’t cook it, boil it or peel it, don’t eat it. Other rules of thumb: Avoid raw fruits and vegetables, unpasteurized dairy products, and cold salsa, salads and sushi that have been left at room temperature.
“It’s also important to note that foods that are served in more expensive restaurants aren’t necessarily safer,” Kelts said.
Kelts recommends eating foods that are well-cooked, canned food that has just been opened, bread and other dry products, and raw fruits and vegetables that have been peeled. When eating uncooked fruits and veggies that can’t be peeled, it’s important to soak them in a solution of one liter of water combined with one teaspoon of bleach for 30 seconds. Wash with boiled, bottled or filtered water before eating.
When experiencing diarrhea, it’s vital to drink lots of water to replenish lost fluids. Travelers’ diarrhea typically resolves in 2-7 days without additional treatment. If dehydration is severe, Kelts recommends a balanced salt solution. Bring along powder sport drink/electrolyte mixes or use the following recipe: 1 quart or liter of water + ½ teaspoon of table salt + 2 tablespoons of sugar.
In addition to offering safe eating advice and making sure patients are adequately immunized, Kelts and team inform patients about insect precautions, motion sickness, altitude sickness, blood clots and can even answer questions about traveling with children, traveling while pregnant, and personal safety.
If a traveler picks up a bug while overseas, the clinic is equipped with physicians who are able to diagnose and determine treatments for individuals when they return home.
Ghana-bound Frank knows that no trip is 100% worry-free even when playing it safe, but he’s thrilled for an amazing opportunity.
“I’m excited to see a different world view and to see what else is out there,” Frank said of his upcoming trip. “And I’m not afraid of catching typhoid or yellow fever.”
A bonus for sure.

Wednesday, May 27, 2015

New Yellow Fever Vaccination in Pune, Sassoon Hospital.

As per a personal communication from a traveler,

YELLOW FEVER VACCINATION IS NOW AVAILABLE IN SASSOON HOSPITAL (OPD BUILDING - ROOM NO. 80), PUNE. ONLY ON MONDAY 0900 TO 1200 HRS LIMITED ONLY FOR 30 PERSONS. COST RS.310/- PER PERSON

I would like other travelers to confirm this and share their experiences with us as well, 

Friday, May 22, 2015

AIIMS Bhubaneswar starts vaccination for yellow fever - great news for Eastern India !

BHUBANESWAR : In a major relief to those travelling to African countries, AIIMS Bhubaneswar has become the first institute in Odisha to give vaccine against yellow fever. Dr Vikash Bhatia, who is the nodal officer for the vaccine, said it would help travellers from Odisha who had to earlier go to Kolkata or Delhi to get the mandatory vaccine before travelling to the endemic countries.The institute is giving the vaccine at the designated centre on every Monday by charging Rs 300. In Indian Journal of Community and Family Medicine launched by AIIMS recently, Bhatia highlights that more yellow fever vaccination centres are required in India with at least one centre in every state to provide hassle free services. "Due to increase in international travel, more people in India requires Yellow Fever vaccination and the demand will continue to increase. People from states without the vaccination centres have to travel a long distance which may go up to hundreds of Kilometres or at times," he wrote. Validity of Yellow Fever vaccine starts from the 10th day of receiving the vaccine and lasts for 10 years from the day of vaccination. Hence persons from non-endemic areas need a booster every 10 years. Passengers travelling to YF endemic countries are advised to take vaccination 10 days before arrival in those countries, he wrote in the editorial. Yellow fever is endemic in rural areas of West Africa & South America and has never been reported in India. Fatality rate is very high and there is no cure for Yellow Fever. Prevention through vaccination is the only available option to decrease deaths. In India, there are only 27 locations in 10 states and 2 Union territories which have the facility to vaccinate for yellow fever, Bhatia said.
Comment: This is a welcome initiative by the Govt of Odisha. I would love to have some feedback by anyone who has taken the vaccine at this (or any other government) center.

Thursday, May 14, 2015

If Mosquitoes Love You, It's In Your Genes - Huffington Post

When mosquito season rolls around, people light citronella candles, slather themselves with repellant and cover up as much skin as possible to protect against annoying, painful bites. While those tactics can help somewhat, the truth is that your genes determine whether or not mosquitoes are attracted to you, according to a recent study published in the scientific journal PLOS One.
In a small but intriguing pilot study that compared identical twins to fraternal twins, researchers at the London School of Hygiene and Tropical Medicine found that mosquitoes were similarly attracted to identical twins, who have the exact same genes. Fraternal twins, on the other hand, seemed to either repel or attract mosquitoes at very different rates.
If the finding is replicated in larger trials, then teasing out the genetic factors that determine mosquito attractiveness could one day lead to a more effective way to repel the flies, said senior author Dr. James Logan in a press release.
"If we understand the genetic basis for variation between individuals, it could be possible to develop bespoke ways to control mosquitoes better, and develop new ways to repel them,” he said. "In the future, we may even be able to take a pill which will enhance the production of natural repellents by the body and ultimately replace skin lotions."
mosquito twins
At the London School of Hygiene and Tropical Medicine, identical twins place their hands in a Y-shaped tube filled with mosquitoes to see how attractive they smell.
To test whether mosquitoes would be more or less attracted to certain twins, each study participant was paired up with their sibling and instructed to place one hand in the forks of a Y-shaped tube. Then researchers then released mosquitoes into the middle tube to see how many insects would fly to one hand versus another.
The experiment on 18 identical twin pairs and 19 non-identical twin pairs revealed that genes play a role in mosquito-attractiveness at a level comparable to how genes play a role in inherited height or IQ. Because it’s already known that mosquitoes are attracted to certain body odors, the researchers hypothesize that the genes that control body odor are the ones playing a role in mosquito attractiveness.
Intuitively, people who attract all the bites during a summer BBQ party when no one else does may already know that they are especially tantalizing to mosquitoes, and that they need to take more precaution than others to avoid itchy welts. But figuring out the best way to repel mosquitoes is about more than just keeping your bare legs bite-free during summer months.
Mosquito-borne diseases like malaria and dengue affect millions around the globe. The faster we can get to controlling mosquito bites, the faster we can put an end to deaths and disfigurement caused by these diseases. Indeed, for the twin experiment, researchers used a type of mosquito called Aedes aegypti, which is notoriously difficult to control or eliminate and is known for its ability to transmit dengue, yellow fever and other diseases to human beings.
The best way to protect against mosquito bites is to use insect repellant on skin and clothes, cover up more skin and avoid being outside during high-mosquito times (from dusk to dawn), according to the Centers for Disease Control and Prevention. Scientific trials have shown that anecdotal strategies such as consuming lots of garlic, vitamin B and beer are not effective at repelling mosquitoes.

ALSO ON HUFFPOST:

Sunday, May 3, 2015

Hepatitis A outbreak reported in US travelers to Mexico - CDC

CDC: Hepatitis A in Mexico (Tulum)
Center for Disease Control and Prevention: Travel Notices: May 1, 2015
As of May 1, 2015, a total of 27 cases of hepatitis A have been reported in US travelers who went to Tulum, Mexico.
All of the people traveled between the dates of February 15, 2015, and March 20, 2015.
CDC recommends that travelers to Mexico get vaccinated against hepatitis A and follow all food and water précautions.
What can travelers do to prevent hepatitis A?
  • Get a hepatitis A vaccine:
  • Eat safe foods
  • Drink safe beverages
  • Practice hygiene and cleanliness
If you feel sick and think you may have hepatitis A
 
Talk to your doctor or nurse if you feel seriously ill, especially if you have symptoms, including a fever, yellow eyes or skin, stomach pain, dark urine or fatigue.  
 
Avoid contact with other people while you are sick
 

Traveling to Varanasi, India from abroad - Diarrhea - what to do?

Q: Dear Doctors

I have been traveling for 8 months and am now in Varanasi. I have had recurring problems with my digestion that has started to worry me in recent weeks. While in Nepal last month i experienced the worst gas of my life, which smelled distinctly sulphuric. This was accompanied by more than a week of intense diarrhea. The doctor at the local hospital was convinced i had giardiasis but when he took a fecal sample the results were negative. I took a course of ayurvedic medicine to combat giardiasis and the problem went away, only to return less than 2 weeks later, this time without the sulphuric smell. I have now had diarrhea for more than a week, waking up every morning with severe stomach pain until i go to the toilet.  Can you advise me of what i should do? I don't speak enough Hindi to get myself properly understood at local hospitals, and i find these doctors do not have the time to listen to the history of my problems. i am worried i have a parasite or
 some kind of contracted disease and do not know where to go to get this checked out. From Varanasi I plan to go north towards Rishikesh. Please can you advise me?

Many thanks,

A: 
Hi,
This is Dr Gupta, from TravelSafe Clinics.
Unfortunately I would be unable to diagnose your problem without a physical examination,
I would advise that you should consider getting a Stool Examination done CONSECUTIVELY for 3 days.
Send the reports by scanning them if there is any abnormality.
Treatment for Traveler's Diarrhea would be recommended in this situation.
A course of OFLOX-ORNIDAZOLE (FOLOX OZ) twice a day after food for 3 days may do wonder for your ailment.
Along with this I would recommend continuous use of a probiotic (good bacteria). ECONORM packets OR capsules 1-2 times a day THROUGHOUT your stay may prevent recurrent episodes of Delhi Belly as well !
Warm regards
Dr Gaurav Gupta, MD
Travel Health Specialist

Saturday, May 2, 2015

There is hope for fighting dengue fever in Brazil - Bloomberg News


A cup of cloves, a half-liter of alcohol and a dollop of body oil: You won't find this homemade mosquito repellent in Brazilian drugstores, but the recipe went viral after a worried sanitarian posted a cell phone video on Facebook last week.
Amid one of their worst outbreaks of dengue fever -- 460,000 people infected and 132 dead this year -- Brazilians are understandably jumpy. That humming sound is the mosquito Aedes aegypti, a familiar pest storied for spreading yellow fever throughout tropical America and now enjoying a comeback as the vector for what has become a 21st-century pandemic.
Once a mostly Asian affliction, the dengue virus has gone global because of breakneck urbanization, bad management of water, haphazard public health care and travel on jets that can take passengers anywhere overnight. A 2013 study in Nature reckoned that dengue had infected 390 million people that year, with 94 million falling ill.
The outbreak is especially severe in the Americas, which have seen a 30-fold increase in the disease over the past 50 years. Counting hospitalization and sick leave, the disease costs the region at least $2.1 billion a year, says the Pan American Health Organization.
Brazil alone accounts for six of every 10 reported cases of illness from dengue worldwide.
There is no vaccine or cure for dengue, leaving Latin Americans reaching for the bug juice and praying for a scientific breakthrough. "The only weapon we've had till now is mosquito control," said immunologist Jorge Kalil Filho, who directs Instituto Butantan, a research center in Sao Paulo.
And yet follow-through on the protocol for combating insects is lax, partly because it was once such a success: Armies of bug killers all but eliminated the offending mosquito last century, then holstered their spray guns when yellow fever subsided in the 1960s. Urbanites didn't help by routinely ignoring official calls to do their part even as mosquitoes multiplied in their potted plants and rubbish.
And although dengue is a global scourge, it has drawn far less research funding than diseases such as HIV and Ebola. "We're hung up on mortality," Duane Gubler, a leading dengue expert with Duke-NUS Graduate Medical School, in Singapore, told me. "Because dengue has relatively low fatality rates, it gets far less attention."
Adding to the woes is global warming, which experts fear could expand the frontiers of the heat-seeking mosquito. Last year, Japan reported its first dengue outbreak in 70 years, and France is on the alert.
Now Aedes aegypti has come roaring back and with it not just dengue but older diseases, like yellow fever and chikungunya, an African virus making its debut in the Americas.
The good news is that prevention is making progress. Researchers at the University of Sao Carlos are tinkering with chemical deterrents, such as turmeric extract, which leaves mosquito larvae vulnerable to sunlight. Another Brazilian team is ginning up an ultrasensitive device to detect and trap mosquitoes by monitoring the frequency of their beating wings. Still others are weaponizing mosquitoes, introducing genetic modifications or bacteria into the bugs so that they will produce sterile offspring when they mate.
The most promising -- and vexing -- challenge is developing a vaccine. With four different serotypes, all of them present in the Americas, the virus is a moving target. Coming down with one strain of dengue is no protection against another.
The race is on in Brazil, where tests on three different vaccines are under way. Leading the pack is Sanofi Pasteur, the biotech firm, which after advanced field trials has claimed a 60 percent prevention rate for all strains of the disease and an 80 percent reduction in the hospitalization risk.
Close on their heels is the Instituto Butantan, working with the U.S. National Institutes of Health, which has asked health authorities for permission to launch its third phase of vaccine testing for 17,000 people throughout Brazil.
Earlier trials showed its vaccine was able to trigger antibodies -- "a cellular defense system," said Kalil -- effective against all four strains of dengue, with minimal side effects.
Kalil argued that jumpstarting the final testing phase could clear the way to deliver a vaccine to the public by 2016, much the way the U.S. Food and Drug Administration fast-tracked trial vaccines to deploy during the Ebola outbreak.
Giovanini Coelho, who heads Brazil's national dengue control program, is more cautious. "Many vaccines are a coin toss," he told me. "But we've had 5 million infections in the last five years, so even if we don't have the world's best vaccine, it would still be a blessing."
After years of neglect and mission drift in the public health establishment, Gubler is encouraged. "For the first time in 45 years in the field, I feel fairly optimistic. We have the tools to fight dengue, now we need to assure the funding."
Until the scientists can deliver, Brazilians can brace for their next dengue summer -- and more viral videos on Facebook.
_ Mac Margolis is a Bloomberg View contributor based in Rio de Janeiro.
For more columns from Bloomberg View, visit http://www.bloomberg.com/view 

Comments: With a large number of Indians visiting Brazil for conferences, adventure travel & tourism, it is imperative that they remember to take adequate precautions against mosquito bites, since as mentioned above there  is no vaccine available.